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Race moderates the relationship between obesity and colorectal cancer screening in women

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Abstract

Objective

To determine if the relationship between obesity and usage of colorectal cancer (CRC) screening in women varies when stratifying by race.

Methods

Using nationally representative data from the 2005 National Health Interview Survey, we examined the relationship between obesity and CRC screening for white and African-American women aged 50 and older. Screening usage variables indicated if a woman was up-to-date for any CRC screening test, colonoscopy, or FOBT. We used multivariable logistic regression models that included interaction terms to determine if race moderates the obesity-screening relationship. We also calculated adjusted up-to-date colonoscopy rates using direct standardization to model covariates.

Results

The relationship between obesity and screening differed by race for any CRC screening test (P = 0.04 for interaction) and for colonoscopy (P = 0.01 for interaction), but not for FOBT. Obese white women had a lower adjusted colonoscopy rate (30.2%, 95% CI 25.9–34.8) than non-obese white women (39.1%, 95% CI 36.1–42.2). Obese African-American women, on the other hand, had a higher adjusted colonoscopy rate (41.2%, 95% CI 31.6–51.4) than their non-obese counterparts (35.6%, 95% CI 28.3–43.6). Overall, adjusted colonoscopy rates were lowest among obese white women.

Conclusions

Obesity is associated with lower CRC screening rates in white, but not African-American women.

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Notes

  1. Personal communication with Jeanne Ferrante (New Jersey-Robert Wood Johnson Medical School) regarding unpublished focus group data.

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Acknowledgments

Ms. Leone is supported by the Lineberger Comprehensive Cancer Center’s Cancer Control and Education Program Pre-Doctoral Fellowship (NCI CA057726-16), the University of North Carolina at Chapel Hill Graduate School’s Dr. Thomas S. and Caroline H. Royster Fellowship, and the Triangle Community Foundation’s George H. Hitchings New Investigator Award in Health Research and Training. Dr. Pignone is supported by a National Cancer Institute Career Development Award (K05 CA129166). Special thanks to Rachel Tabak, May May Leung, Lisa Lowenstein and Dr. Dianne Ward for their help with editing this manuscript and to Chris Wiesen at the Odum Institute for the Social Sciences for his statistical assistance.

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Authors and Affiliations

  1. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 1700 Martin Luther King Jr. Blvd., CB#7294, Chapel Hill, NC, 27599-7294, USA

    Lucia A. Leone, Marci K. Campbell, Jessie A. Satia & Michael P. Pignone

  2. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Lucia A. Leone, Marci K. Campbell & Jessie A. Satia

  3. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Jessie A. Satia

  4. Department of Health Behavior and Health Education, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    J. Michael Bowling

  5. Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Michael P. Pignone

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  1. Lucia A. Leone
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  2. Marci K. Campbell
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Correspondence to Lucia A. Leone.

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Leone, L.A., Campbell, M.K., Satia, J.A. et al. Race moderates the relationship between obesity and colorectal cancer screening in women. Cancer Causes Control 21, 373–385 (2010). https://doi.org/10.1007/s10552-009-9469-x

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  • DOI: https://doi.org/10.1007/s10552-009-9469-x

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